CD117、CD34、DOG-1、WT-1 在胃肠道间质瘤中的表达及意义

目的:探讨DOG-1、CD117、CD34、WT-1在胃肠道间质瘤(GIST)中的表达及临床意义。方法:应用免疫组织化学SP法检测DOG-1、CD117、CD34、WT-1在39例GIST患者肿瘤组织中的表达。结果:GIST光镜下主要由梭形细胞和(或)上皮样细胞或多形性细胞混合或单一性组成。DOG-1、CD117、CD34和WT-1在GIST肿瘤组织中阳性表达率分别为92.3%(36/39)、71.7%(28/39)、64.1%(25/39)、23.1%(9/39),四者的阳性表达率在各风险程度组(极低及低度危险性GIST、中度危险性GIST、高度危险性GIST)两两比较中差异均无统计学意义(P>0.05)。DOG-1与CD117相比,在极低及低度危险组中表达有显著差异(P<0.05),DOG-1与CD34相比,在极低及低度危险组、高度危险组中表达有显著差异(P<0.05);WT-1与CD117相比,在中度及高度危险组中表达有显著差异(P<0.05),WT-1与CD34相比,在中度危险组中表达有显著差异(P<0.05)。对照组平滑肌瘤、纤维瘤、神经鞘瘤中CD117、DOG-1在GIST中的表达明显高于其他多种梭形细胞的表达(P<0.05)。结论:DOG1是GIST较为敏感和特异的标记物,WT-1在极低及低度危险性GIST中有一定的诊断价值,在GIST的诊断中加入两者将使患者更加受益。

Expression and Significance of DOG-1, CD117, CD34 and WT-1 in Gastrointestinal Stromal Tumors

Objective: To investigate the expression of DOG-1,CD117,CD34 and WT-1 in gastrointestinal stromal tumors(GIST) and its diagnostic application.Methods: Immunohistochemical SP technique was used to assess the expression of DOG-1,CD117,CD34 and WT-1 in 39 cases of GIST.Results: All 39 cases of GIST consisted of variable proportion of spindle and epithelioid tumor cells or just one type of the tumor cell.The expression rates of DOG-1,CD117,CD34 and WT-1 were 92.3%(36/39),71.7%(28/39),64.1%(25/39),23.1%(9/39).The expression rates of DOG-1,CD117,CD34 and WT-1 have no statistical difference in the group of very low and low risk GIST,moderate risk GIST,high risk GIST(P>0.05),The sensitivity of DOG-1 detection of very low and low risk GIST were significantly higher than those of CD117(P<0.05),The sensitivity of DOG-1 detection of very low and low risk GIST,high risk GIST were significantly higher than those of CD34(P<0.05);The sensitivity of WT-1 detection of moderate risk and high risk GIST were significantly higher than those of CD117(P<0.05),The sensitivity of WT-1 detection of moderate risk GIST were significantly higher than those of CD34(P<0.05).The expression of DOG-1 and CD117 in GIST were much higher than leiomyomas,schwannomas,fibromas(P<0.05).Conclusion: DOG-1 is a sensitive and specific marker for GIST;WT-1 has some reference value in the diagnosis of very low and low risk GIST;more patients will benefit from the joining of DOG-1 and WT-1.